Single-stage reconstruction of composite central neck defects with the double-island vertical rectus abdominis musculocutaneous flap Journal Article
| Authors: | Matros, E.; Cordeiro, P. G. |
| Article Title: | Single-stage reconstruction of composite central neck defects with the double-island vertical rectus abdominis musculocutaneous flap |
| Abstract: | Background: A subset of patients with hypopharyngeal cancer has tumors involving the neck skin and soft tissues in addition to vital structures such as the larynx and alimentary tract. Surgical extirpation creates a complex composite deformity for the reconstructive surgeon. The objective of this article is to describe the rationale for closure of these defects with the double-island vertical rectus abdominis musculocutaneous (VRAM) flap. Methods: Retrospective chart review of all head and neck reconstructions performed over the past 20 years identified 4 patients who underwent reconstruction of combined defects involving less than 50% of the pharyngoesophageal circumference and anterior neck soft tissues. All wounds were closed in a single-stage with a double-island VRAM. Outcomes and complications were reviewed. Results: Indication for resection was locally advanced disease or recurrence with pharyngocutaneous fistula. Mean age was 54 years with a follow-up time of 2 years. The average external skin defect measured 10 × 15 cm. There was no complete or partial flap loss. No major and 2 minor complications were identified. All patients tolerated an oral diet postoperatively. No revisions have been performed. Conclusion: In contrast to perforator flaps where creation of separate skin paddles may not always be possible, the VRAM's robust axial blood supply facilitates formation of 2 independent skin islands in all cases. The external island serves as a flap monitor and obviates the need for a second flap. In conclusion, the double-island VRAM flap is safe, has minimal donor-site morbidity, and reliably accomplishes reconstruction of composite head and neck defects in a single-stage. Copyright © 2011 by Lippincott Williams & Wilkins. |
| Keywords: | reconstruction; hypopharynx; central neck defect; composite; island; vram |
| Journal Title: | Annals of Plastic Surgery |
| Volume: | 66 |
| Issue: | 2 |
| ISSN: | 0148-7043 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2011-02-01 |
| Start Page: | 164 |
| End Page: | 167 |
| Language: | English |
| DOI: | 10.1097/SAP.0b013e3181e05381 |
| PROVIDER: | scopus |
| PUBMED: | 21042179 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 4 March 2011" - "CODEN: APCSD" - "Source: Scopus" |
Altmetric
Citation Impact
BMJ Impact Analytics
Related MSK Work